9. SKIN INCISIONS-
i. I-SHAPED INCISION: EXTENDING FROM THE CHIN STRAIGHT DOWN TO THE SYMPHYSIS PUBIS AND
AVOIDING THE UMBILICUS (BECAUSE THE DENSE FIBROUS TISSUE IS DIFFICULT TO PENETRATE WITH
A NEEDLE, WHEN THE BODY IS STITCHED AFTER AUTOPSY). MOST COMMON METHOD FOLLOWED.
ii. Y-SHAPED INCISION: STRAIGHT LINE OF Y CORRESPONDING TO THE XIPHISTERNUM TO PUBIS
INCISION AND FORKS OF Y RUNS DOWN BELOW THE BREASTS AND EXTENDING TOWARDS THE
ACROMION PROCESS. IT IS DESIRABLE IN THOSE CASES (ESPECIALLY FEMALES) WHERE IT IS
CUSTOMARY TO KEEP A DRESSED BODY FOR VIEWING FOR SOMETIME AFTER DEATH. III.
iii. MODIFIED Y-SHAPED INCISION: AN INCISION IS MADE IN MIDLINE FROM SUPRASTERNAL NOTCH
TO SYMPHYSIS PUBIS. THE INCISION EXTENDS FROM SUPRASTERNAL NOTCH OVER THE CLAVICLE TO
ITS CENTRE ON BOTH SIDES AND THEN PASSES UPWARDS OVER THE NECK BEHIND THE EARS. IT
IS USED WHEN A DETAILED STUDY OF NECK ORGANS IS REQUIRED, E.G. HANGING OR
STRANGULATION.
20. Spleen exposition. Bending
of the greater curvature of
the stomach, diaphragmatic
face, and holding plane of
the lienal organ in the
dissector’s left hand.
opening of the
stomach
Particular of the kidneys and their
vascular connections. the ideal
resection plan is outlined. in red,
opening of the capsule and kidney
removal; in blue, removal of the
capsule and of the ureter; close-up,
the renal arteries.
22. opening of the cervix and the
uterus body. the cervical duct (cD)
and the palmed folds are clearly
shown.
uterus. Side view of the cervix
23. • SKULL AND BRAIN
• TO EXAMINE THE BRAIN, IT IS USUAL PRACTICE TO MAKE AN INCISION THROUGH THE
SCALP FROM BEHIND ONE EAR, PASSING JUST BEHIND THE VERTEX AND ENDING BEHIND
THE OTHER EAR. REFLECT THE TWO FLAPS FORWARD AS FAR AS SUPRA-ORBITAL RIDGES
AND BACKWARDS AS FAR AS THE OCCIPUT. THIS MAY REVEAL ANY FURTHER INJURY TO
THE SCALP. NOTE ANY INJURY, PETECHIAL HAEMORRHAGES, OR OEDEMA; IN PRESENCE OF
FRACTURE, RECORD ITS DIMENSIONS AND CONTOUR.
• INCISE THE TEMPORALIS MUSCLE ABOUT ITS MIDDLE ON EACH SIDE. THE CRANIUM IS TO
BE OPENED BY SAW CUT, THE LINE OF SEVERANCE FOLLOWING A POINT JUST ABOVE THE
SUPERCILIARY RIDGES IN FRONT AND THROUGH THE OCCIPUT BEHIND . A MALLET AND
CHISEL SHOULD NEVER BE USED, AND EVERY CARE MUST BE UNDERTAKEN TO KEEP THE
MENINGES AND BRAIN INTACT. THE RISK OF EXTENDING OR EVEN CAUSING FRACTURES BY
EXCESSIVE HAMMERING IS NOT UNKNOWN. THE REMOVAL OF SKULL CAP IS FACILITATED
BY GENTLY INSERTING AND TWISTING THE CHISEL AT VARIOUS PLACES THROUGH THE CUT.
INSPECT THE SKULL CAP FOR FRACTURES BY HOLDING IT AGAINST THE LIGHT OR TAPPING
IT ON THE TABLE.
38. Incision 1—Through right atrium
Incision 2—On the anterior wall of right
ventricle parallel to interventricular septum
Incision 3—Through tricuspid valve Incision
4—Through left atrium (after reversing
the heart)
Incision 5—Through mitral valve, parallel to
the septum (on anterior wall)
Incision 6—Through aortic valve
39. Another lesser used method is the short axis or
ventricular slicing method (Fig.). With the heart in the
anatomical position, the first slice is made through the
heart at a point about 3 cm from the apex separating
it from the remainder of the heart. Further complete
slices are then made in parallel to this slice, 1 cm
apart, until reaching below the atrioventricular valves.
The remainder is then examined by opening along the
path of blood flow. It is useful if ischemic myocardial
disease is suspected as it clearly
40. heart examination according to the
“Four chambers” method.
Slice method
a heart examination according to the
base method. a circular cut is
performed 2 cm up to the atrio-
ventricular sulco.
41. • COLLECTION OF SAMPLES
i. BLOOD: THE CELLULAR BARRIER OF MUCOUS AND SEROUS MEMBRANES BREAKS DOWN
AFTER DEATH, DUE TO WHICH SUBSTANCES (E.G. ALCOHOL AND BARBITURATES) IN THE
STOMACH AND INTESTINE CAN MIGRATE TO THE ORGANS IN THE THORAX AND
ABDOMEN LEADING TO ERRONEOUS RESULTS. BEFORE AUTOPSY, 10-20 ML OF BLOOD
CAN BE DRAWN FROM THE FEMORAL (BEST SAMPLE), JUGULAR OR SUBCLAVIAN VEIN BY
A SYRINGE. BLOOD SHOULD NEVER BE COLLECTED FROM THE PLEURAL OR THE
ABDOMINAL CAVITIES, AS IT CAN BE CONTAMINATED WITH GASTRIC OR INTESTINAL
CONTENTS, LYMPH, MUCUS, URINE, PUS OR SEROUS FLUID.
ii. CSF: IT IS COLLECTED BY LUMBAR PUNCTURE OR FROM THE CISTERNA MAGNA BY
INSERTING A LONG NEEDLE BETWEEN THE ATLANTO-OCCIPITAL MEMBRANE. DIRECT
ASPIRATION OF CSF CAN BE DONE FROM THE LATERAL VENTRICLES OR THIRD VENTRICLE
AFTER REMOVAL OF THE BRAIN.
46. • PRESERVATION OF SAMPLES
• THE IDEAL SAMPLES ARE THE ONES IN WHICH NOPRESERVATIVE HAS BEEN ADDED AND SENT TO
CFSL WITHINFEW HOURS. BUT, PRACTICALLY, IT USUALLY GETS DELAYED.•
• THE SPECIMEN IS PRESERVED AT 4°C UNTIL THEY AREANALYZED. FOR LONG-TERM STORAGE, IT
TO BE KEPTIN FREEZER (-10°C).
• IN ORDER THAT PUTREFACTION MAY NOT SET IN AND RENDERCHEMICAL ANALYSIS DIFFICULT,
CERTAIN PRESERVATIVES AREUSED.
1.VISCERA
• THE MOST COMMONLY USED PRESERVATIVE FOR VISCERAIS SATURATED SOLUTION OF COMMON
SALT.IT IS EASILYAVAILABLE, CHEAP AND EFFECTIVE PRESERVATIVE.•IN CASES OF SUSPECTED ALKALI
OR ACID POISONING(EXCEPT CARBOLIC ACID), RECTIFIED SPIRIT IS USED.16 IT ISNOT USED IN CASES
OF SUSPECTED POISONING WITH: •ALCOHOL•CHLOROFORM•KEROSENE•ETHER•CHLORAL
HYDRATE•PHOSPHORUS•FORMALDEHYDE•FORMIC ACID•PARALDEHYDE•ACETIC ACID
